Tracheotomy tube assembly

ABSTRACT

A TRACHEAL DEVICE, FOR USE I/N TRACHEOTOMY IN WHICH A MAIN TUBE IS INSERTED IN THE TRACHEA. A LATERAL ORIFICE THEREIN ACCOMMODATES THE REDUCED END PORTION OF AN EXTERNAL LATERAL TUBE WHICH IS FITTED AFTER THE TRECHEOTOMY. A CLIP HAVING HOOKS THEREON PASSES THROUGH THE EXTERNAL TUBE AND AN INTERNAL TUBE IS PUSHED IN TO FORCE THE HOOKS TO ENGAGE ON THE INTERIOR OF THE MAIN TUBE, THUS HOLDING THE TWO TUBES AND THE CLIP IN PLACE.

P 1971 R. GULLING 3,605,751

TRACHEOTOMY TUBE, ASSEMBLY Filed 001;. 10, 1969 L j? l United StatesPatent 3,605,751 TRACHEOTOMY TUBE ASSEMBLY Roger Culling, Saint-Fons,France, assignor to Rhone-Poulenc S.A., Paris, France Filed Oct. 10,1969, Ser. No. 865,447 Claims priority, application France, Oct. 10,1968,

169,502 rm. 01. A611) 17/24;A61m /00; F161 41/00 U.S. c1. 12s-ss1 6CIalmS ABSTRACT OF THE DISCLOSURE A tracheal device, for use intracheotomy in which a main tube is inserted in the trachea. A lateralorifice therein accommodates the reduced end portion of an externallateral tube which is fitted after the tracheotomy. A clip having hooksthereon passes through the external tube and an internal tube is pushedin to force the hooks to engage on the interior of the main tube, thusholding the two tubes and the clip in place.

The present invention relates to a tracheal device which permits therespiration of the patient without closing the natural passages.

A tracheal device is used in those cases where the nor mal respiratoryfunctions of the nose or throat are injured. This use is normal when thesurgical operation of tracheotomy has to be undertaken. The tubesforming the tracheal device are introduced, partly directly into theinterior of the trachea and partly through the laterally formed opening,and then they are assembled.

Such an assembly of tracheal tubes permits the trachea to be broughtinto communication either with the nose and the throat, or directly withthe ambient air, while short-circuiting the injured surfaces of the noseand throat.

Different types of tracheal tubes permitting respiration through thenatural passages are known. The assembly of tubes which is most usuallyemployed comprises a polytetrafiuorethylene tube having thin walls andpierced laterally by an orifice, of which one end has rounded edges tofacilitate the introduction thereof into the interior of the trachea.After incision of the trachea, a curved silver cannula is introducedthrough the opening thus formed and through the lateral orifice of thepolytetrafiuorethylene tube.

This tube assembly is difiicult to assemble correctly. In actual fact,if the orifice formed in the polytetrafiuorethylene tube is too small,the introduction of the silver tube is difiicult. If this orifice is toolarge, the two tubes are not rigid and the polytetrafiuorethylene tubecan be displaced in the trachea. Moreover, the length of thepolytetrafluorethylene tube has to be adjusted to the desired dimensionsbefore it is introduced into the trachea. For this purpose, one end ofthe tube is cut off and thus it has traumatising sharp edges.

An attempt has been made to obtain a correct assembly of twopolytetrafiuorethylene tracheal tubes by screwing a straight tube intothe lateral orifice of the main tube placed in the trachea. However, asthe tracheal tubes have thin walls, the engaged threaded and tappedsurfaces are insufficient to form a sufiiciently resistant asice semblywhich does not become loose. This assembly remains inadequate, even ifthe lateral tube is caused t penetrate into the interior of the maintube. Since a considerable part of the section of the main tube is shutoff in this way, the respiration of the patient through the naturalpassages is considerably impaired and it is only with difiiculty thatthe mucus is evacuated.

According to the present invention there is provided a tracheal devicecomprising a main tube having a laterally extending orifice in the sidewall, an external lateral tube including a portion of reduced exteriorsize adjacent one end thereof, shaped to fit snugly within said orifice,an internal lateral tube axially slidable within said external lateraltube, abutment means on the internal lateral tube, abutting the externallateral tube to prevent the internal lateral tube projectingsubstantially inwardly, with respect to the main tube, beyond the innerend of the external tube, a clip of inert material fitted within theexternal lateral tube and exteriorly of the internal lateral tube and atleast one hook on said clip such that when the internal lateral tube isslid fully into said external lateral tube, said at least one hooklocates interiorly of said main tube to retain the external and internallateral tubes in position on the main tube.

In order that the invention will be better understood the followingdescription is given, merely by way of example, reference being made tothe accompanying drawings, in which:

FIG. 1 is an exploded sectional elevation of one embodiment of trachealdevice according to the invention; and

FIG. 2 is a sectional elevation of a modified form of the main tube ofFIG. 1.

The device illustrated in FIG. 1, includes a main tube 1, adapted to beintroduced into the interior of the trachea, the tube being formed witha lateral orifice 2, the axis of which is inclined at an angle a above aplane perpendicular to the axis of the tube. The angle a is between 0and 45 and preferably between 10 and 30. At least one end 3 of the maintube has rounded edges so as not to cause traumatism when it isintroduced into the trachea.

A lateral tube, intended to be fixed on the orifice 2 of the main tube,includes an external lateral tube 10 and an internal lateral tube 12.The external tube is cylindrical and its external diameter is largerthan the diameter of the orifice 2. One end 11 is of reduced diameter soas to fit snugly within the orifice 2 over a length sufficient to permitits complete engagement in the orifice.

The internal tube 12 is also cylindrical and has the external diametersuch as to permit it to slide with light friction inside the tube 10,one end being formed with a collar 13.

Between the sleeves 10 and 12 and fitted into grooves formed for thispurpose is a clip 14 of resilient and inert material, formed by at leasttwo arms, the ends of which are bent to form opposite and outwardlyfacing hooks 15 and 16. The arms of the clip are joined at the other endby a connection ring 17 which is adapted to bear against the end 18 ofthe tube 10. The length of each arm of the clip is accuratelydetermined, so that the ring 17 comes into contact with the end 18 ofthe tube 10, when the hooks 15 and 16 reach the opposite end 11 of thetube. They can be opened outwardly, either under the effect of theelasticity of the arms of the clip or under the pressure of the tube 12as it is fitted.

In order to fit the device according to the invention, after havingperformed a tracheotomy on the patient, the tube 1 is introduced intothe trachea and it is suitably adjusted. The external lateral tube isinserted laterally through the formed opening and the end 11 of thesleeve is fitted into the orifice 2. The clip 14 is introduced into theinterior of the tube 10 after having manually pressed the hooks 15 and16 together, and they are pressed in until the connecting ring 17 abutsagainst the end 18 of the tube 10. Then the tube 12 is introduced intothe interior of the tube 10 until the collar 13 is stopped. It is thencertain that the arms of the clip are bearing satisfactorily against theinternal wall of the tube 1 and that consequently the hooks ensure thelocking of the lateral tube on the main tube 1. The extraction of thisdevice is easily elfected by operating in the reverse manner. If theelasticity of the clip is insufiicient to ensure the unlocking, it issufiicient to make a quarter turn of the clip 14, by gripping it bymeans of the ring 17, so that the hooks re-enter the interior of thebore of the tube 10.

In the modification of the main tube which is illustrated in FIG. 2, thetube 1 is divided into three elements of the same external diameter.These include a central section 4 which is threaded and/ or tapped ateach end and is formed with a lateral orifice 2, and two similar endsections 5 and 6, of which the ends 7 and 3 have rounded edges and ofwhich the ends 8 and 9 are tapped and/ or threaded over a length whichis between a quarter and three quarters of the total length of each endsection.

The length of a tapped portion is preferably greater than thecorresponding threaded length. It is thus possible to cut oil eachtapped portion to the desired length, perpendicularly of its axis, andto adjust the length of the main tube for each patient, while keepingits two rounded and non-traumatising ends.

The main tube has a thin wall, preferably between 0.8 and '3 mm. thick,the thickness being such that the tube has a sufiicient rigidity as afunction of the material being employed and has the smallest possibleratio between external section and internal section. The externaldiameter of the main tube is selected according to the internaldimensions of the patients trachea, and the diameter of the lateralorifice 2 is preferably between a third and two thirds of the externaldiameter of the main tube.

The elements forming the lateral tube preferably have a length which isbetween 3 and 10 cm., the arms of the clip 14 being formed by wires orpreferably by fine lamellae. It is generally suificient to have two armsdisposed in the plane of symmetry of the device. These arms aregenerally bent over at their end to form hooks, one at 90+0r and theother at 90oc. At the opposite end, they may be soldered on theconnecting ring 17, the diameter of which is between the internal andexternal diameters of the tube 10. The two arms of the clip may befitted between the tubes 10 and 12 by means of two flats (not shown)provided on the tube 12.

As materials for forming the tubes, it is possible to employ variousrigid or semi-rigid plastic materials which are substantially neutral tothe secretions of the organism. Thus, as non-limiting examples, it ispossible to use polytetrafiuorethylene, thermoplastic polyesters,polyamides, polyvinyl chloride, polyolefines. The end sections arepreferably made of a material which is easy to cut with a surgeonsknife. The clip should be formed or plated with a stainless metal oralloy. It can for example consist of stainless steel with 18% ofchromium, 8% of nickel and 2% of molybdenum, or any other stainlessalloy, but it can also consist of noble metals, such as gold, silver,platinum, or of metal or alloy provided with a coating protecting itagainst oxidation.

It is obvious that variants of this device can be pro vided; forexample, one or more hook elements can be provided, which may or may notbe made integral, and

4 various forms of hooks can be used. The main tube can also be dividedinto only two sections.

Preferably, the tracheal end of the external lateral tube terminates ina cylindrical surface, so that after insertion into the orifice of themain tube, the said end is fiush with the internal wall of the maintube.

Advantageously, the portion of the lateral tube of largest diameter endson the tracheal side in a cylindrical surface with a radiussubstantially equal to the external radius of the main tube, the twocylindrical surfaces being substantially coaxial.

The device according to the invention has outstanding advantages. It isformed of simple elements, which can be easily placed in position,assembled and extracted. The assembly thereof offers absoluute safety.This device has the outstanding feature of being formed by two tubes,each of a practically constant effective section throughout the length.The respiration of the patient is thus made particularly easy, eitherthrough the natural passages or by short-circuiting the naturalpassages. The evacuation of mucus and the cleaning of the tubes areconsiderably facilitated. The lengths of the end sections of the maintube can be adjusted exactly for each patient before being fitted,without having ends with sharp edges and thus without causing anytraumatism. Finally, the extraction of the device on completion oftreatment is easy and rapid, this resulting in a saving of time for thesurgeon and less pain for the patient.

I claim:

1. A tracheal device comprising, in combination:

(a) a main tube having a side wall;

(b) a laterally extending orifice in said side wall;

(0) an external lateral tube;

(d) first and second ends to said external lateral tube;

(e) a portion of reduced exterior size adjacent the first end of saidexternal lateral tube, shaped effective to fit snugly within saidorifice in the side wall of said main tube;

(f) an internal lateral tube axially slidable within said externallateral tube;

(g) abutment means on said internal lateral tube abutting said externallateral tube, efiective to prevent said internal lateral tube projectingsubstantially inwardly, with respect to said main tube, of said firstend of said external lateral tube;

(h) a clip of inert material fitted within said external lateral tubeand exteriorly of said internal lateral tube having at least one armextending to said first end of said external lateral tube in a directionparallel to the axes of said lateral tubes; and

(i) at least one hook on said clip extending generally radiallyoutwardly, whereby when said internal lateral tube is slid fully intosaid external lateral tube, said at least one hook locates interiorly ofsaid main tube, effective to retain said external and internal lateraltubes in position on said main tube.

2. A tracheal device as defined in claim 1, wherein said abutment meanscomprises a collar on said internal lateral tube, said collar abuttingsaid second end of said external lateral tube.

3. A tracheal device according to claim 1, wherein said internal andexternal lateral tubes are cylindrical and wherein said portion ofreduced exterior size is of cylindrical external configuration, and saidorifice in said side wall is circular.

4. A tracheal device as claimed in claim 1, wherein said laterallyextending orifice has an axis which is at an angle to the perpendicularto the axis of said main tube, said angle being between 0 and 45.

5. A tracheal device as defined in claim 1, wherein said clip comprisesa pair of parallel arms, ends to said arms, a ring connecting to one endof each of said arms located to abut said second end of said externallateral tube, and

6 wherein two hooks are arranged, one at the other end of ReferencesCited each arm, to extend outwardly from one another.

6. A tracheal device as defined in claim 1, wherein said UNITED STATESPATENTS main tube comprises three tubular elements of the same 3,297,0271/1967 Rlfsch external diameter, including a central section in which 53,322,126 5/ 1967 Rusch said laterally extending orifice is formed,threaded ends 3,461,877 8/1969 Morch 128351 to said central section, andtwo similar end sections, each having a first and a second end, thefirst ends of said sec- CHANNING PACE Pnmary Exammer tions beingthreaded to co-operate with the threaded ends U 5 C1 X R of said centralsection, and the second ends having rounded 1O edges. 285-191

